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CBD and the Endocannabinoid System


CBD Oil and Antidepressants

Antidepressants are prescribed by physicians to help patients cope with symptoms of stress, anxiety, and depression. In some instances, antidepressant treatments are coupled with more natural remedies.

CBD (cannabidiol) oil is a perfect example. CBD is extracted from hemp or marijuana plants and is a natural substance that relieves both physical and psychological conditions. CBD has been an effective therapy to treat cases of depression, and some doctors recommend CBD oil to reduce the effects of neurodegenerative disorders, a common cause of anxiety.

In a society that’s becoming more inclined to ingest organic substances, there’s growing demand to substitute medications with natural remedies, like CBD. Let’s look at how to combine CBD oil and antidepressants, and also when it’s best to avoid mixing different treatment methods.

What medications interact with CBD oil?

Before answering that, it’s best to understand how CBD functions within the bodily system.

CBD is used to support the endocannabinoid system that lives within each human being. The endocannabinoid system is a complex series of cells, known as endocannabinoids, that function as neurotransmitters. They flow through the body and attach themselves to cannabinoid receptors, which subsequently reduce physical aches and pains.

Additionally, relief applied to cannabinoid receptors also mitigates the effects of past trauma. People who use CBD oil for PTSD have achieved a degree of balance in hormones and stress that percolate throughout the mind. Anxiety and depression are two common symptoms of PTSD, and the effects of both conditions are dramatically reduced when the endocannabinoid system is reset to a healthy neutral.

CBD oil side effects

In most circumstances, it’s presumably safe to combine CBD oil with antidepressants or other medication. However, physicians encourage people to be cautious when mixing different forms of medicine.

Dr. Peter Grinspoon, an instructor in medicine at Harvard Business School, instructs patients to find a reputable supplier when purchasing CBD products. In some circumstances, supplements that were advertised as CBD remedies were discovered, upon inspection, to contain little to nothing of the substance. Furthermore, some suppliers mislabel products that instead contain high doses of THC, the substance within marijuana plants that gets users high.

The other x-factor is the amount of unknowns. CBD is still a relatively new medicinal remedy and, according to Dr. Greenspan, there is still much to discover about the substance.

CBD does have hypothetical drug interactions; the question is whether these are clinically important or not.

What medications affect CBD oil?

To date, the only FDA approved CBD-derived medication is a drug called Epidiolex, which is used to treat very rare forms of epilepsy. As a result, scientific evidence on the relationship between CBD oil and other medications is limited to the tests involving Epidiolex.

One clinical trial involved a patient in 2011 who was treated for severe epileptic episodes using a drug called warfarin. The patient was referred to a CBD trial to test if a more natural therapy could help mitigate the symptoms. The patient was taking approximately 7.5 mg of warfarin daily, and he was administered a dose of 5 mg of CBD oil at the onset of the trial. CBD doses were increased an additional 5 mg every two weeks.

When the CBD doses began, the patient’s International Normalized Ratio (INR) spiked as the cannabidiol first interacted with the warfarin. However, over the course of the trial, the warfarin dose decreased by 30% and the patient’s INR stabilized to a healthy normal.

It was suggested that CBD competed with the same enzymes within the body as warfarin. If true, CBD was a potent inhibitor of warfarin and the competing medications were responsible for the spike in the patient’s INR.

It remains to be seen if combining CBD oil and antidepressants will have similar effects and if there are any drugs that should not be taken with CBD oil.

Can you take CBD oil with high blood pressure medication?

Given that CBD effectively combats feelings of stress and anxiety, physicians suspect cannabidiol oil is a potent treatment for high blood pressure. In fact, a study involving nine randomly selected patients concluded with reduced resting blood pressure, increased blood pressure caused by stress, and other associated symptoms of increased heart rate.

When combining CBD with blood pressure medication, the net benefits are more difficult to ascertain. CBD can inhibit the cytochrome P450 enzyme system, which is responsible for oxidizing fatty acids and xenobiotics in various mammals, including humans. Blood pressure medications like metoprolol or valsartan enable the P450 system to do its job.

If the two methods of treatment should converge, the net effect slows down how both CBD and the blood pressure medication interact with fatty acids in the body. As a result, it can take a longer period of time for patients to feel the effects of both their medication and the CBD oil.


What is known about CBD oil and antidepressants is that there is some form of a symbiotic relationship between the two. One in six Americans is known to take antidepressants or other forms of antipsychotic medication, which means there are many potential patients who will benefit from a more detailed understanding of the CBD-antidepressant connection.

It remains to be seen what the true scope of that relationship is, and what it means for people who are treating underlying conditions with medication. While CBD, on its own, has proven to be an effective remedy for depression, anxiety, and other conditions, there are still many unknowns about cannabidiol’s ability to function in tandem with antidepressant medication.

The best course of action is to consult with your primary care physician if you’re on medication and wish to take CBD as a more natural supplement. Your doctor will know the details of your condition and have a well-informed opinion on whether CBD oil is the right choice for you.

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